TB in Yemen: economic and health problems
In Yemen, about 12,000 people are infected with TB while about 1,400 die every year due to the disease.
TB is an infectious disease caused by a bacterium called Mycobacterium Tuberculosis. It primarily affects the lungs, but it can also affect organs in the central nervous system, the lymphatic system, and the circulatory system.
Khadija Al-Domaini, head of the private sector at the National Health Media Center, told the Yemen Times.
She explained that anyone who uses the transportation system in Yemen is exposed to TB, but she also indicated that some people have strong enough immune systems to quickly destroy the bacteria once they enter the body. Some of them may carry the bacteria but will not be contagious and will not display symptoms.
“Most people who get infected with the bacteria that cause tuberculosis actually do not show any symptoms of the disease,” she explained.
According to Al-Domaini, the symptoms include sudden weight loss, tiredness, fatigue, short of breath, fever, night sweats (even when the weather is cold), chills, loss of appetite, a persistent cough (lasting for 3 or more weeks), or coughing up blood. (Although this is not always the case, sometimes a symptom is coughing without blood.)
Al-Domaini indicated that there are 333 districts in Yemen that are covered by TB prevention services whereas 265 of them have special laboratories for TB diagnosis.
She said that there are two phases of treatment; the first is an intensive phase of treatment that continues for two months and is monitored daily by the family or healthcare staff. The second phase is a complemented by the first, but it continues every day for four months.
“The patient in the first phase will appear to have recovered from most of the symptoms of TB. However, if the treatment is discontinued before the conclusion of the second phase, the patient will suffer a serious setback,” explained Al Domaini.
Othman Al-Hassosh, the head of Media Health Education for TB prevention program, talked about the experience of two brothers from the Hajja governorate who had TB in 2008, saying: “One of them stopped the treatment after three months when he felt he was better, but his mistaken assumption directly caused his death. The other brother continued his treatment and was completely healed. He now volunteers in the Health Center.”
The stigma associated with TB makes it difficult to treat in Yemeni society, thus causing an increase in the mortality rate. “Some families are ashamed of TB, forcing them to travel from one district to another to get medical treatment away from their neighbors.”
Al-Hassosah added that the stigma of associated with the disease often have harsh results, even leading to killing in some cases.
He recalled, “In 2006 in the Amran governorate, when a young man was affected by TB and his health sharply deteriorated, his family decided to throw him off of a mountain which immediately killed him.”
Al-Domaini said that many Yemenis are not aware that pulmonary TB isn’t contagious after two weeks of treatment. “They should continue through all the treatment phases and they shouldn’t consider the disease to be a stigma.”
She explained: “If the patient doesn’t complete the whole treatment process, TB in this case will become resistant to the medication and the risk will increase, because we will need to add a stronger medicines as long as patient’s body gets used to it.”
She said that the TB patient should not sit in a crowded room and that it should be well-ventilated and sunny. She advised the patient not to spit or shout to help prevent bacteria from spreading. She also urged patients to cover their mouth and nose while coughing or sneezing.
“Eating and drinking from the same plate, spoon or glass as the patient can increase the risk of spreading TB within the family,” Al-Domini said.
According to Al-Domini, TB is dormant in the bodies of the majority of Yemenis.
“If the person has a strong immune system, TB will not affect his or her body in the same way as a person with a weak immune system,” she said.
Al-Domini pointed out that healthy nutrition is the best form of protection against different diseases as it plays an essential role in strengthening the immune system. She also mentioned that people with chronic diseases such as diabetes and hypertension are twice as likely to carry TB unless they are careful about controlling their health.
“People should stop spitting in public places,” she said, adding that it is an uncivilized and unsanitary habit.
“It is considered to be the easiest way for TB to spread in our society.”